Germany has a good healthcare system. For diabetics there are in addition to family doctor medical care, diabetes specialist practices (DSP) and rehabilitation clinics. However, the care of diabetics in our country is not optimal. What are the causes and what can we do? Regional differences in the definition and demarcation of a DSP from other diagnoses, too few diabetologists and DSP, advertising for unhealthy food and insufficient self-monitoring are just a few of the causes. A registration of the diabetics in a national register similar to that in Sweden, a significant improvement of prophylaxis and the training of diabetology professionals are possible approaches for a positive change.